新型Y型椎弓根螺钉在骨质疏松人工骨模块下的生物力学研究

发布时间：2018-06-14 16:16

本文选题：骨质疏松人工骨模块 + Y型椎弓根螺钉　；参考：《中国修复重建外科杂志》2017年10期

【摘要】：目的评价新型设计的Y型椎弓根螺钉(Y type pedicle screw,YPS)在骨质疏松人工骨模块(简称"模块")中的生物力学稳定性。方法将模块随机分成3组(n=20),用手钻垂直钻入模块中,制备直径3.0 mm、深30.0 mm的钉道。分别将YPS、膨胀式椎弓根螺钉(expansive pedicle screw,EPS)、中空骨水泥椎弓根螺钉(bone cement-injectable cannulated pedicle screw,CICPS)打入已制备好钉道的各组模块中。12 h后行X线检查,并在E10000万能材料试验机上分别对YPS组、EPS组、CICPS组进行生物力学稳定测试,记录最大轴向拔出力、最大旋出力和周期抗屈最大载荷。结果 X线片观察示,YPS组主钉和中芯钉均被周围的聚氨酯材料包绕,中芯钉从主螺钉的中下1/3穿出后,与主钉形成15°夹角,插入的中芯钉最低点与主螺钉位于同水平线上;EPS组螺钉尖端明显膨胀,形成爪型结构;CICPS组骨水泥主要分布于螺钉前部,在骨小梁中弥散,形成稳固的"螺钉-骨水泥-骨小梁"复合体。生物力学检测示,YPS、EPS、CICPS组的最大轴向拔出力分别为(98.43±8.26)、(77.41±11.41)、(186.43±23.23)N,最大旋出力矩分别为(1.42±0.33)、(0.96±0.37)、(2.27±0.39)N/m,周期抗屈试验的最大载荷分别为(67.49±3.02)、(66.03±2.88)、(143.48±4.73)N。CICPS组各指标均明显高于YPS组和EPS组,差异有统计学意义(P0.05);YPS组最大轴向拔出力和最大旋出力矩显著高于EPS组,差异有统计学意义(P0.05),但YPS组和EPS组间比较最大载荷差异无统计学意义(P0.05)。结论相比于EPS,YPS能有效提升其在模块中的最大轴向拔出力和最大旋出力,为骨质疏松条件下的螺钉设计和不同固定方式选择提供了新思路。
[Abstract]:Objective to evaluate the biomechanical stability of a new Y type pedicle screw Y type pedicle screwYPS in osteoporosis artificial bone module. Methods the modules were randomly divided into 3 groups, which were drilled perpendicularly into the module by hand drill, and the diameter was 3.0 mm and the depth was 30.0 mm. The expanded pedicle screwCICPSs (hollow bone cement pedicle screws) were injected into each module of the prepared nail canal for X-ray examination after 12 hours, and the bone cement-injectable cannulated pedicle screwCICPSs of the hollow bone cement pedicle screw were injected into the each module of the nail canal, respectively, after 12 hours, the bone cement-injectable cannulated pedicle crewCICPSs of the hollow bone cement pedicle screw were injected into each module which had been prepared. The biomechanical stability of YPS group EPS group CICPS group was tested on the E10000 universal material testing machine, and the maximum axial pull-out force, maximum rotation force and cycle flexural maximum load were recorded. Results X-ray observation showed that the main nail and the middle core nail in the YPS group were all wrapped in the surrounding polyurethane material, and the middle core nail was perforated from the middle and lower third of the main screw and formed a 15 掳angle with the main screw. The lowest point of the inserted core nail and the main screw are located on the same horizontal line as the EPS group. The CICPS group has a claw-type structure. The cement of the CICPS group mainly distributes in the anterior part of the screw and diffuses in the trabeculae of the bone. Form a solid "screw-bone cement-trabecular" complex. The biomechanical tests showed that the maximum axial pull-out force of the YPS EPSN CICPS group was 98.43 卤8.26, respectively 77.41 卤11.41 卤11.41 卤23.23Nm, and the maximum rotation torque was 1.42 卤0.33Nm, 0.96 卤0.372.27 卤0.39Nm, respectively. The maximum load of the periodic flexural test was 67.49 卤3.02mnm, 66.03 卤2.882.2ng, 143.48 卤4.73N.CICPS respectively, which was significantly higher than that of the YPS group and the EPS group, and the maximum axial pull-out force of the CICPS group was significantly higher than that of the YPS group and the EPS group, respectively, and the maximum axial pull-out force of the CICPS group was significantly higher than that of the YPS group and the EPS group, respectively. The maximum axial pull-out force and maximum spin-out moment of YPS group were significantly higher than that of EPS group, and the difference was statistically significant (P 0.05), but there was no significant difference in maximum load between YPS group and EPS group. Conclusion compared with EPS, YPS can effectively enhance the maximum axial pull-out force and maximum spin-out force in the module, which provides a new idea for the screw design and the choice of different fixation methods in the condition of osteoporosis.
【作者单位】：重庆医科大学附属永川医院骨科;
【基金】：重庆市卫生计生委医学科研项目(2015ZDXM020)~~
【分类号】：R580;R687

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